The Effect of Social Support or Dislocation on Mental Health

‘The effect of social support or dislocation on mental health’ This essay will look at the effect of dislocation on mental health, what factors contribute to poor mental health from biological and psychosocial perspectives. We begin by looking at what factors promote positive mental health before looking at the role of social context and the environment in negating these very factors. We look at an example where the environment can make a negative contribution to mental health.

Moving the focus to a more biological perspective we examine how an individual might be genetically more predisposed to depression and poor mental health via the serotonin transporter gene. Stress as a precursor to poor mental health is then explored in relation to the hypothalamic–pituitary–adrenal (HPA) axis and then in the wider psychosocial context of hierarchy and inequality in society. Finally we look at some case studies that underpin how an individual becomes isolated after experiencing poor mental health and how can serve to reinforce dislocation and serve as an obstacle to recovery.

Social context and dislocation Individuals who report good subjective well being demonstrate a lack of negative emotion such as hostility, they cope with the everyday hurdles such as stress (Blaumeister and Leary, 1995) and they also demonstrate relatively good health (Marks and Shah, 2005). Positive psychology also cites the importance of purpose in an individual’s life-a sense of engagement (Marks and Shah, 2005) with a lack of materialist values-those in pursuit of materialist gratification purport lower well being (Kasser, 2002).

The role of individual differences and how we interact with the environment is offered as a key influence of well-being. Lately, social cohesiveness-each person forms part of a social network, experiences the feeling of belonging to a greater good (Post 2007). The key aspect here is belonging. In dislocation an individual experiences a loss of identity in becoming excluded from society-they do not feel as they belong-often they feel undervalued, unappreciated and a lack of self worth as a result of unemployment or family breakdown.

Alexander (2000, 2008) and Peele and Degrandpre (1998) found evidence to support the role of social context in developing a drug addiction: simply put, people with a developed social network suffer better mental health than those who are living in a psychological void detached from society. The role of social context affecting mental health is illustrated in Vancouver. This city has a high immigrant population with a statistically high alcohol and drug death rate and arrests for drug use (Alexander, 2000).

Social adversity and stress that challenge this large immigrant population are thought to be key factors in developing mental health disorders. This theme of stress as an precursor to mental health and addiction is collaborated by Klanecky et al. (2009) who found individuals exposed to early childhood adversity and social disruption are more likely to experience addiction later in life. Stress, biology and depression This is also supported by Caspi et al (2003) who sees the impact of stress as a key trigger to impaired mental health in early years.

Caspi et al. , found individuals with either one or two ‘short’ alleles in the 5-HTT (serotonin transporter) gene who experienced three of more stressors (stress or maltreatment) in the five years prior to depression were significantly more likely to be depressed. The role of societal factors such as early stress that mediate their influence through genetics in gene expression further supports the role of the environment and how as individuals we engage with it with varying degrees of success due to our own biology and inheritance.

One response to stress one is triggered by the amygdala that triggers corticotropin-releasing factor (CRF) that in turn alerts the sympathetic nervous system (SNS). This CRF in turn triggers hypothalamus to produce more CRF and the pituitary gland to produce adrenocorticotropic hormone (ACTH). The adrenal glands then produce corticosteroids into the blood. An overactive hypothalamic–pituitary–adrenal (HAP) axis mechanism described here can damage the glucocorticoid receptors.

An individual with an overactive HPA axis due to prolonged stress will produce a constant barrage of glucocorticoids and these are thought to weaken neurons in the hippocampus and prefrontal cortex. As the prefrontal cortex is responsible for the control of emotions (Drevets 1998) damage to this area will invariably impact on an individual’s sense of well being. Interestingly, rats injected with CRF exhibit symptoms similar to depression (Arborelius et al. , 1999). In the context of real world a dysregulated HPA axis can offer real tangible evidence of how stressful living can make a biological contribution to imparing mental health.

Self esteem, identity & adversity Evidence of an overactive HPA axis sits well within a wider psychobiological perspective. Stress within a psychosocial setting was researched by Gilbert (1989, 1992) in animal studies. The research found that individuals are sensitive to social status and hierarchy. Individuals who are outranked and defeated and subordinated (unequal) are likely to feel humiliated and ashamed. These effects would impact on a person’s self esteem and undermine their sense of self work, confidence, attractiveness and identity and would trigger depression.

This might go some way to explain the high incidence of mental health disorder mentioned previously in Vancouver. Research was developed by Brown et al. , (1995) in identifying major triggers in the six months before the onset of depression. Similarly humiliation and entrapment (31%) followed by loss and being alone (9%) were the most significant provoking events. This is certainly supported by case of Naha (section 1. 1. 1 book1) who experienced severe depression after the death of her parents and divorce after moving from a good social support network to a big city.

Naha sees herself as a failure and as such her engagement with wider society has diminished. Naha found challenging life events coupled with a lack of support network in her immediate environment eroded her ability to cope and pushed her to social isolation and depression. In a similar way Samuel (vignette 4. 1, book 1) after suffering a traumatic accident experienced a manic episode followed by deep depression, only increasing his isolation in seeking help from his GP for sick leave. Being dislocated from mainstream society may not necessarily trigger poor mental health but the isolation that accompanies a mental health condition serves o exacerbate the sense of dislocation and it is this aspect that is often detrimental to improved mental health. As we have seen key factors influence mental health and to what extent an individual can become dislocated from mainstream society. Key factors such as an individual’s biology, their environment, how an individual interacts with that environment and how they negotiate a social support network, their affective style in coping with stress and adverse life events along with genetic influences can all combine to contribute to a strong complex biopsychosocial modal of an individual’s mental health.